Dealing on the more recondite aspects of healthcare creeping into our doorsteps. Like how research into chemical weapons protection can also help us "civilians".

Tuesday, April 7, 2009

Lasik: An Eyeglass Eliminating Miracle Cure?

Ever since the medical procedure became widely available to anyone, does Lasik fulfill the promise of freeing each and every eyeglass-wearers from the tyranny of their own eyeglasses?

By: Ringo Bones

In our contemporary vanity obsessed society, it seems like it was only a matter of time before another everyday necessity was deemed to be as useless as a Victorian-era whalebone corset by the more-money-than-common-sense fashionistas. Their latest consensus-casualty: eyeglasses. Given that the hype behind contact lenses waned faster than everyone’s interest on the Iran-Contra affair of the late 1980s. Medical science has thus been given another impetus with a far greater motivational factor than a multi-million dollar grant in order to divert everyone’s navel gazing about how not everyone of us is born with perfect 20 / 20 vision. Thus making the Lasik surgery the latest elective surgery novelty since Botox treatments.

Lasik or laser-assisted in situ keratomileusis is a type of refractive laser surgery performed by ophthalmologists for correcting the 3 most common forms of eye defects due to a misshapen cornea that necessitates the wearing of eyeglasses to enable the afflicted to see normally in 20 / 20 vision. These eye defects are myopia or near-sightedness, hyperopia or farsightedness, and astigmatism. The first patent for Lasik was granted by the US Patent Office to Dr. Gholam A. Payman, M.D. on June 20, 1989 as US Patent # 4,840,175; “METHOD FOR MODIFYING CORNEAL CURVATURE”. Lasik became the most popular elective procedure in Asia since it was made available. At the Asian Eye Institute in Manila, for instance, about 1,000 people avail of the procedure every year jut to abandon the use of their eyeglasses. And the number of people who had the procedure had been growing at a rate of 20% annually.

Even though the procedure is far from risk-free, Lasik is nevertheless somewhat ingenious in its simplicity. The procedure starts by opening the anaesthetized eye, then the surgeon marks the cornea with soluble ink as a guide in cutting and repositioning of the flap. A suction ring provides an increased pressure in the eye so that it becomes firm thus making it easier to cut cleanly. Next, a motorized blade slices the cornea. The surgeon then lifts the flap, exposing the inner surface of the cornea that will reshaped by a cool laser. Then the patient’s corneas are reshaped depending on the kind of eye defect the patient has. Those with near-sightedness are corrected by flattening the center of the cornea. Those with farsightedness are usually fixed by removing a ring of tissue around the center of the cornea, thus making the cornea steeper. While those with astigmatism, the misshapen oblong-shaped cornea is reshaped to make it more spherical.

Even though Lasik has a high-rate of success in comparison to other procedures, it is not for everyone and you could be designated a poor candidate once your ophthalmologists checks your eyes. Especially if you have severe vision problems, have glaucoma, cataracts or retinal problems, is still under 18 years of age, is currently pregnant, or your corneas aren’t thick enough for safe Lasik surgery. Also, Lasik is no panacea against age-related macular degeneration or those vision problems that come with old age.

Even though ophthalmologic surgeons are highly regulated by law – even as far back as ancient Babylon circa 1,000 BC. Where the fees of eye surgeons were rigidly fixed by law and were quite generous. At the time when the state of the art in eye surgery was the ultra-sharp obsidian scalpel – instead of today’s femto-second pulse laser for eye surgery – a successful operation on a rich freeman costs 10 shekels of silver, as much as a chariot mechanic makes in a year. The same operation on a slave was priced at 2 shekels. However, the life of the surgeon – though financially rewarding – was not without it’s own hazards. If the wealthy freeman lost the sight of his eye in the operation, the surgeon’s hand was cut off; if the slave was blinded, he or she has had to be replaced by the doctor.

However in our contemporary society, for an industry that promises clarity and transparency, many eye centers – especially those in Asia where the Lasik is relatively new - have kept their patients in the dark about the risks and realities. Governments are more than likely of no help either because there are still no restrictions on who can buy medical instruments and equipment. But most government and private hospitals insist that doctors have some form of medical accreditation before they are allowed to perform eye surgery. Though there are still no high-profile medical malpractice or wrongful death lawsuits involving Lasik, it is still seen by the “Old Guard” in the medical community as a “Wild West” in terms of costs versus benefits.

Good as the procedure really is, many patients find the post-operative consequences of Lasik a little bit hard to live with before they vanish over time. Like light sensitivity and night-vision problems. Which could spell bad news for astronomers and working military and law-enforcement snipers. Plus additional surgery has to be done as follow-ups / touch-ups when the results fall below expectations. And the jury is still out over the long-term effects on patients who had undergone Lasik surgery. If you can live with these caveats and you had recently grown to hate yourself wearing eyeglasses, then Lasik might be for you.

1 comment:

Contact lenses ARE available for people with astigmatism. There is considerable time and skill involved in fitting patients with these lenses but it can be done for ALL astigmatisms if the patient is highly motivated to try.